Provider Demographics
NPI:1922044189
Name:NOR-LEA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:NOR-LEA HOSPITAL DISTRICT
Other - Org Name:NOR-LEA HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-396-6611
Mailing Address - Street 1:1600 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-2813
Mailing Address - Country:US
Mailing Address - Phone:575-396-6611
Mailing Address - Fax:575-396-0318
Practice Address - Street 1:2827 N. DAL PASO
Practice Address - Street 2:SUITE 117
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-2062
Practice Address - Country:US
Practice Address - Phone:575-392-6314
Practice Address - Fax:575-392-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6204A2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2116Medicaid
NMN2116Medicaid